Drug interactions
Pefloxacin + Ramelteon
Severity: Moderate
Pefloxacin and Ramelteon: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Pefloxacin inhibits CYP1A2, the main enzyme metabolizing ramelteon, and may raise ramelteon exposure. This could increase next-day somnolence and dizziness.
What this interaction means in plain words
Pefloxacin and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Pefloxacin belongs to Anti Bacterial; Ramelteon belongs to Central Nervous System.
Why it happens
Inhibition of CYP1A2-mediated ramelteon metabolism by pefloxacin.
What to do
Monitor for excessive sedation and consider an alternative hypnotic or antibiotic. Strong CYP1A2 inhibitors such as fluvoxamine are contraindicated with ramelteon, so avoid adding such agents.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ramelteon
- Calcium / magnesium / potassium / sodium oxybates + Ramelteon Contraindicated
- Fluvoxamine + Ramelteon Contraindicated
- Ramelteon + Sodium oxybate Contraindicated
- Alfentanil + Ramelteon Moderate
- Amitriptyline + Ramelteon Moderate
- Amobarbital + Ramelteon Moderate
Other interactions of Pefloxacin
- Pefloxacin + Tizanidine Contraindicated
- Clozapine + Pefloxacin Major
- Duloxetine + Pefloxacin Major
- Pefloxacin + Theophylline Major
- Asenapine + Pefloxacin Moderate
- Caffeine + Pefloxacin Moderate
Frequently asked questions
Can I take Pefloxacin with Ramelteon?
MediHelp rates the interaction as moderate. Pefloxacin and Ramelteon can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Pefloxacin inhibits CYP1A2, the main enzyme metabolizing ramelteon, and may raise ramelteon exposure. This could increase next-day somnolence and dizziness.
How serious is the interaction between Pefloxacin and Ramelteon?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for excessive sedation and consider an alternative hypnotic or antibiotic. Strong CYP1A2 inhibitors such as fluvoxamine are contraindicated with ramelteon, so avoid adding such agents.
What other medicines interact with Ramelteon?
MediHelp also lists interactions of Ramelteon with, for example, Calcium / magnesium / potassium / sodium oxybates, Fluvoxamine, Sodium oxybate. The full list is on the Ramelteon page.
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